Billy Carl Fuller Jr., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

13851 Issued in NC

Practice address

13915 Mopac Service Rd
#200
Austin, TX 78728

Phone

(336) 608-2715

NPI assigned

Feb 17, 2020

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1581897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1497388581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 MEADOW OAK DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274068284",
            "telephone_number": "336-608-2715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13915 MOPAC SERVICE RD",
            "address_2": "#200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78728",
            "telephone_number": "336-608-2715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "BILLY",
        "middle_name": "CARL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-17",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202009409",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "13851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Full Potential Home Therapy, LLC
• Full Spectrum Healing LLC
• Full Spectrum Wound Care Alliance
• Fuller Rehabilitation and Consulting Services, Inc.
• Betty J. Fuller, LVN
• Catherine Fuller, SLP
• Devon A Fuller, APRN, FNP-C
• Ersten Fuller, M.A., LPC
• Jason P. Fuller, D.C.
• Jennifer Quinn Fuller, LPC

• Speech-Language Pathologist in Austin, TX
• Providers in Austin, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.